Front Dent Med. 2026 Aug 11;7:1895392. doi: 10.3389/fdmed.2026.1895392. eCollection 2026.
ABSTRACT
BACKGROUND: Platelet-rich fibrin has shown regenerative potential in periodontal treatments; nonetheless, patients with Type 2 diabetes mellitus (T2DM) may experience altered biological activities. Therefore, this study aimed to evaluate the regenerative potential and growth factor release profiles of advanced platelet-rich fibrin (A PRF) and injectable platelet-rich fibrin (i-PRF) derived from participants with controlled and uncontrolled T2DM.
METHODS: This study compared n = 87 (29 per group) participants-controlled T2DM, uncontrolled T2DM, and Healthy non-diabetic groups-analysing blood samples for HbA1c, platelet count, and growth factors like Vascular endothelial growth factor (VEGF), Platelet-derived growth factor-BB (PDGF-BB), Insulin-like growth factor-1 (IGF-1), Transforming growth factor-beta 1 (TGF-β1), Transforming growth factor-beta 2 (TGF-β2) via Enzyme-linked immunosorbent assay (ELISA), assessing cytocompatibility with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays, and employing statistical methods like Analysis of variance (ANOVA) correlation, and regression.
RESULTS: PRF derived from participants with uncontrolled T2DM demonstrated significantly reduced PDGF-BB and TGF-β2 release compared with healthy participants in both A-PRF (P = 0.016), i-PRF (P = 0.033), and A-PRF (P = 0.002) and i-PRF (P = 0.0034. VEGF release was significantly lower in uncontrolled T2DM than in well-controlled T2DM in both A-PRF (P = 0.0096) and i-PRF (P = 0.0023). Compared with the uncontrolled T2DM group, well-controlled T2DM exhibited significantly higher VEGF release in both A-PRF (P = 0.0096) and i-PRF (P = 0.0023), and significantly higher IGF-1 (P < 0.05) and TGF-β2 (P = 0.033) levels in i-PRF. Platelet counts were comparable across the study groups, whereas cell viability was highest in PRF from healthy participants. HbA1c was not independently associated with the evaluated growth factor concentrations in multivariable analyses.
CONCLUSIONS: A-PRF and i-PRF derived from participants with well-controlled T2DM exhibited biological properties comparable to those of healthy non-diabetic individuals, whereas uncontrolled T2DM was associated with reduced release of key growth factors, indicating compromised healing potential. These findings suggest that achieving good glycaemic control may optimize the biological performance of PRF for periodontal regenerative therapy. However, the present findings are based on in vitro analyses; confirmation through well-designed prospective clinical studies remains essential before these findings can be translated into routine clinical practice.
PMID:42643293 | PMC:PMC13503254 | DOI:10.3389/fdmed.2026.1895392
